The death of a young pregnant woman has thrust the issue of abortion center-stage
in Ireland, with pro-choice campaigners blaming the country’s ban on abortion
for the woman’s death. However, even a quick perusal of the facts reveals a
much more complex scenario. Pro-life advocates insist the tragic case is being
used by those trying to overturn Ireland’s pro-life legislative framework.
There have even been accusations that Catholic health-care ethics led to the
death.

Savita Halappanavara native of India who moved to the west of Ireland
some years agowas 17 weeks pregnant when she went to the hospital on October
21, complaining about back pain. The 31-year-old was admitted to Galway
University Hospital. According to her husband, doctors determined she was
having a miscarriage. Little else is known officially, apart from the fact that
a week later, Halappanavar had died from septicaemia, a blood infection.

The only account of the events leading up to her death come from Halappanavar’s
distraught husband, who claims his wife asked for a termination of her
pregnancy when it became clear that she was miscarrying. He insists that
doctors refused because of the presence of a fetal heartbeat. His wife would be
alive, Praveen Halappanavar says, if doctors had induced labor and ended the
pregnancy as she requested. He told the Irish
Times that his wife died because Ireland is a Catholic country and follows
Catholic medical ethics.

Cue a torrent of anti-Catholic commentary on social media sites and from
prominent journalists and commentators. Despite a lack of facts, the collective
outcry was that this tragic incident had occurred because the hospital acted with
a Catholic ethos. The country’s Minister for Health, Dr. James Reilly,
intervened to warn against prejudging the situation before the conclusion of
two independent investigations surrounding the death.

He said that the question of a Catholic ethos preventing or inhibiting medical
personnel from carrying out proper medical treatment, as defined by the Medical
Council, had been raised. “I have no evidence of that, but, again, I am not
going to preclude what a coroner’s court will find, and I want to await that
independent investigation that a coroner always undertakes,” Dr. Reilly told the
Irish parliament, in response to questions about the incident.

While no one wants to intrude on Mr. Halappanavar’s obvious grief over
the death of his wife, medical experts and bioethicists have been quick to
express their view that Ireland’s ban on abortion had nothing to do with Mrs.
Halappanavar’s death. They insist that guidelines from the Irish Medical
Council are perfectly clear that pregnant women must be given all necessary
medical treatment.

The Pro-Life Campaign, the country’s largest anti-abortion lobbying
group, described as “deplorable” calls for new abortion legislation in the wake
of the tragic case.

PLC spokesperson Dr. Ruth Cullen said, “We extend our deepest sympathies
to the husband and family of Ms. Savita Halappanavar, who died from pregnancy-related
complications.”

“It is deplorable that those who want to see abortion available here are
exploiting Mrs. Halappanavar’s tragic death when the Medical Council Guidelines
are very clear that all necessary medical treatment must be given to women in
pregnancy,” Cullen said.

She said the PLC welcomed “the fact that a thorough investigation to
establish what went wrong is taking place.”

“It is also vitally important to acknowledge at this time that Ireland,
without induced abortion, is recognized by the UN and World Health Organization
as a world leader in protecting women in pregnancy and is safer than places
like Britain and Holland, where abortion is widely available,” she insisted.

Cullen’s contention is backed up by one of the country’s most senior
obstetrics practitioners. Dr. Sam Coulter-Smith, head of the Rotunda Maternity
Hospital in Dublin, has said he sees no evidence of confusion in Irish medical
ranks over whether or not a woman can have a termination if her life is at
risk.

“I think most of us who work in obstetrics and gynecologythere may be
individual differences, but the majority would be of the view that if…there is
a risk of death and we are dealing with a fetus that is not viable, there is
only one answer to that question, we bring the pregnancy to an end,” he said.

Coulter-Smith is also clinical professor of obstetrics and gynecology at
the Royal College of Surgeons in Dublin. “This case probably does not have a
lot to do with abortion laws,” he said. “It is a clinical scenariosomeone in
the process of miscarriage [who] had infective complications as a result of
that process. Whether or not if the situation had been actively managed in the
24-36 hours preceding the tragedy of the baby’s death, would that have changed
anything? No one can answer that.”

“What is reasonably clear is that in a position where senior clinicians
feel a woman’s health and life is at risk then it is permissible in this
country to end the pregnancy,” he said.

Catholic health-care ethics do allow for actions to be taken to save the
life of the mother, even at the risk of ending the life of the unborn child.
Pope Pius XII in 1951 told the Italian Union of Midwifes that, “if, for
example, the saving of the life of the future mother, independently of her
pregnant condition, should urgently require a surgical act or other therapeutic
treatment which would have as an accessory consequence, in no way desired or
intended, but inevitable, the death of the fetus, such an act could no longer
be called a direct attempt on an innocent life.”

“Under these conditions the operation can be lawful, like other similar
medical interventions,” Pope Pius insisted.

It is unclear if inducing Halappanavar’s labor would have saved her life.
What is clear is thatcontrary to the reported comments from her husbandCatholic
teaching would not have stood in the way of such an operation.

The case has provoked rage in Halappanavar’s native land. The Times of India has accused Ireland of “murdering”
her, while atheist Richard Dawkins stated on Twitter, “Irish Catholic bigotry
kills woman.”

There are serious questions to address, not least of which is
establishing when doctors should have realized that Halappanavar had a
life-threatening infection.

Eilis Mulroy, who works with the Pro-Life Campaign, says the question
that needs to be asked is: “Was Mrs. Halappanavar treated in line with existing
obstetrical practice in Ireland? In this kind of situation the baby can be
induced early (though is very unlikely to survive). The decision to induce labor
early would be fully in compliance with the law and the current guidelines set
out for doctors by the Irish Medical Council.”

“Those guidelines allow interventions to treat women where necessary,
even if that treatment indirectly results in the death to the baby. If they
aren’t being followed, laws about abortion won’t change that,” she says.

Mulroy said, “This terrible situation should not be used to push an
ideological agenda to introduce abortion. Any debate on the issue of abortion
should be carried out in a reasonable manner. It does no service to Savita’s
memory to use her tragic death as an impetus for legislation that is bad for
both women and their babies.”

While Ireland is recognized as a worldwide leader in maternal health, the
two inquiries into Halappanavar’s death take place against the backdrop of
another investigation into the practices of Irish health professionals when
dealing with pregnant women.

As a result of an undercover investigation published by the Irish Independent last month, the government
has launched an inquiry into crisis pregnancy counseling services in Ireland
that were found to be giving illegal and life-threatening advice. The
undercover investigation was carried out at 11 state-funded crisis pregnancy
counseling services and revealed that some pregnancy counselors were giving
women dangerous and illegal advice, such as telling them they could hide their
abortions from their doctors, which could endanger their lives. Some counselors
advised women how to smuggle illegal abortion pills into Ireland and take them
without medical supervision.

As Savita Halappanavar’s death continues to focus the world’s attention
on Ireland’s abortion laws, David Quinn, director of the religious think-tank the
Iona Institute, sees something sinister in the media coverage.

“There has been a tremendous and unseemly rush to judgment in this case,”
he said.

Quinn believes Halappanavar’s death “is being used to advance the
argument that Ireland must change its law on abortion before we know the full
facts. It is also being used to falsely and unjustly give the impression that
Ireland is an unsafe place for pregnant women, when the opposite is true.”

“The bottom line is that we cannot draw any decisive conclusions about
what happened in this tragic case until we do know all the facts,” says Quinn.

The ban on abortion predates Irish independence in 1922, and goes back to
an 1861 British law that has remained in force. This was strengthened by a 1983
constitutional amendment that recognized the equal right to life of the mother
and child. Controversially, however, the country’s Supreme Court ruled in 1992
that this created a right to abortion where there was a substantial risk to the
lifeas opposed to the healthof the mother. This has never been legislated and
pro-life campaigners have considered the ruling deeply flawed.

The government is expected to publish the report
of an expert group on the issue within weeks. The group has been given the task
of advising the government on how it should respond to a 2010 judgment of the
European Court of Human Rights (ECHR) concerning the country’s abortion
legislation. While the case found that Ireland has a right to ban abortion, it
found that the country must clarify the 1992 Supreme Court judgment.

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